Treatment for Borderline Personality Disorder: Dialectical Behavior Therapy Training
Borderline Personality Disorder (BPD) is a distressing and potentially fatal mental illnesses that is rising greatly in our society, particularly among young women. Young women mostly, but also men, who have experienced the sudden disappearance of usually a father, but really, any major support system during childhood, are the individuals who are most commonly found to have acquired the disorder. BPD is marked by extreme mood swings, impulsive behaviors, feelings of perceived or real abandonment, self injury/self harming behaviors like cutting and attempted suicide, and occasions of transient psychosis.
People with Borderline Personality Disorder usually have a very hard time regulating their emotions and tend to shift their moods and what might seem like their entire perspective on certain things from one radical extreme to another within only minutes, at times. It has so far been recognized as an incurable illness that often leaves the patient as well as his or her doctors, therapists and loved ones, exhausted and frustrated due to a seemingly lack of improvement over time. In fact, it is common knowledge among members of the psychiatric community that people with Borderline Personality Disorder have a hard time finding treatment after they’ve been diagnosed because many doctors or therapists do not want to spend hours, months, years of their time trying to treat someone that by the books is doomed for failure, is knowingly needy and dependent, and who by definition takes measures to personally put harm to his or her body or attempt frequent suicides.
And their tendency to shy away from these patients is definitely understandable, but is it fair to the Borderline patient? What if doctors refused to see people with AIDS because they were in fear for their life? That would be discrimination. But for some reason, the Borderline stigma continues to exist under the table. Because there seemed to be no way to treat this catastrophic case. Until now. Until the wonders of Dialectical Behavior Therapy training are becoming more popular. Now, hopefully, the stereotypes and fear toward and of Borderline patients will dissipate and these patients can start to expect the proper level of care for themselves for once.
Marsha Linehan, of the University of Washington, is known in the psychiatric/psychological community as, shall we say, the Mother of DBT. DBT, or Dialectical Behavior Therapy training is a means of treating the BPD with a psychosocial, biosocial approach with a focus on behavior modification and practice of recognizing reality, regulating emotions, and increasing interpersonal skills in a positive manner, and finding proper ways of managing stress and fighting self harming impulses. Linehan officially broke the theory of the DBT approach to the public in 1991 after studying for decades with people who had attempted suicide. She taught them various means of controlling their moods from an almost third person, objective standpoint and ways to, in a crisis, “do what works” to get out of the scary moment immediately without leaving yourself inflicted.
In 1993 Linehan published the Skills Training Manual for Treating Borderline Personality Disorder, known to those in the “Borderline community” as the “red and black workbook”. The skills training manual was designed as a guide for therapists and patients to follow upon deciding to take a dialectical approach to the Borderline Personality symptoms. She trains small groups at a time of therapists all over the world wishing to be certified in the DBT form of therapy. And though there are very few DBT specific-trained therapists out there, especially ones trained by Linehan herself, when you find one it will be quite obvious that they really know their stuff. Dialectical Behavior Therapy training is really hard concepts and series of techniques to grasp, not just for a patient suffering from mental disabilities but for anyone. Such is why the red and black book has become such a great reference source for practitioners of the therapeutic method. The book, though written for a therapist or doctor who is teaching DBT in a group therapy setting, can also be used one on one by patient and doctor/therapist and is often done so.
The Skills Training Manual for Treating Borderline Personality Disorder is written like a dense, tedious textbook that most students dread during college years. Perhaps this is the case because the Dialectical Behavior Therapy training method is more of a philosophy than anything else. The workbook takes the reader through a few major sections of the Dialectical Behavior Therapy training approach: Mindfulness Skills, Interpersonal Effectiveness Skills, Emotion Regulation Skills and Distress Tolerance Skills. The first of the group, mindfulness, also referred to as “core mindfulness”, is the study of getting to a specific meditative like state in your body and mind by which you can act and react in or to situations in appropriate ways that tend to combat the tendencies of your illness. Core mindfulness is just that; the core, of the entire dialectical behavior therapy training spectrum. Because of this, then, it is usually preferred to be taught first among the group of skills and is often repeated several times over and over.
For instance, Elizabeth Murphy, a Linehan-trained therapist at McLean Hospital in Belmont, Massachusetts, who runs several Dialectical Behavior Group Therapy training sessions daily, believes so strongly in the power of mindfulness that she takes the group back to try and relearn the concept after every set of skills training. One starting the group, though not required, will often, just by a matter of odds, end up beginning their group therapy training with the mindfulness studies and that is exactly how Murphy plans it. She was known to tell a group that not only was it the “core” of Dialectical Behavior Therapy training, but mindfulness was also the hardest skill to figure out. Therefore she insists on practicing it over and over again, so as to keep reminding the group what it is about. Many people believe that mindfulness is one of those “use it or lose it” things.
Other therapists in the U.S. or internationally who teach dialectical behavior therapy training for their patients with Borderline Personality Disorder might teach the Skills Training Manual for Treating Borderline Personality Disorder in a different order and many outpatient therapists for one on one sessions simply use the Dialectical Behavior Therapy training as a root and background for their individual once a week discussions with the patient. But whether the DBT is administered imposingly or if it is a more indirect method of skills training, one thing can be certain and that is that Marsha Linehan is queen of the trade. And though her theories have not yet been picked up by the mainstream, everyday psychiatric field and practices, the DBT approach is spreading rampantly throughout the elite society of psychiatrists and therapists who are a part of large psychiatric institutions and schools like Massachusetts General Hospital and McLean Hospital and who are the first to try out new methods of treatment for any mental disorder.
This is only the first step, but the next, which is to spread the word to the general public and gain trust from your everyday average small town psychiatrists and therapists is more difficult. However, with the latest breakthrough in the press about Marsha Linehan’s Dialectical Behavior Therapy training, the skills and techniques are being put to the test with extensive research to attempt to prove her theories correct. Word in the psychiatric community is that Harvard University will soon conduct one of those exact research projects. DBT for BPD. Imagine the positive outrage that will occur when the public finds out Dialectical Behavior Therapy training for Borderline Personality Disorder is really legitimate. I think pigs are going to fly. I can’t wait to watch. Go buy or borrow Marsha Linehan books related to DBT now and don’t get lost in the dust.
